School of Leadership and Education Sciences, University of San Diego, San Diego, CA 92110, USA.
School of Public Policy and Administration, Carleton University, Ottawa, ON K1S 5B6, Canada.
Int J Environ Res Public Health. 2024 Jun 29;21(7):853. doi: 10.3390/ijerph21070853.
It is estimated that three million people annually experience homelessness, with about a third of the homeless population being served by Federally Qualified Health Centers (FQHCs). Thus, FQHCs, dependent on government funding for financial viability, are vital to the infrastructure addressing the complex issues facing people experiencing homelessness. This study examines the relationship between various government funding streams and the number of homeless patients served by FQHCs. Data for this study come from three publicly available databases: the Uniform Data System (UDS), the IRS Core files, and the Area Resource File. Fixed-effects models employed examine changes across six years from 2014 to 2019. The results suggest that, on average, an additional homeless patient served increases the expenses of FQHCs more than other patients and that federal funding, specifically Health Care for the Homeless (HCH) funding, is a vital revenue source for FQHCs. We found that the number of homeless patients served is negatively associated with contemporaneous state and local funding but positively associated with substance use and anxiety disorders. Our findings have important implications for the effective management of FQHCs in the long term and for broader public policy supporting these vital elements of the social safety net.
据估计，每年有 300 万人经历无家可归，其中约三分之一的无家可归者由联邦合格的健康中心 (FQHC) 服务。因此，依赖政府资金维持财务生存能力的 FQHC 对于解决无家可归者面临的复杂问题的基础设施至关重要。本研究考察了各种政府资金流与 FQHC 服务的无家可归者人数之间的关系。本研究的数据来自三个公开可用的数据库：统一数据系统 (UDS)、IRS 核心文件和地区资源文件。采用固定效应模型来检验 2014 年至 2019 年六年期间的变化。结果表明，平均而言，每增加一名无家可归的患者，FQHC 的支出就会增加，超过其他患者，而联邦资金，特别是无家可归者医疗保健 (HCH) 资金，是 FQHC 的重要收入来源。我们发现，服务的无家可归者人数与同期州和地方资金呈负相关，但与物质使用和焦虑障碍呈正相关。我们的研究结果对 FQHC 的长期有效管理以及支持这些社会安全网重要组成部分的更广泛公共政策具有重要意义。
